LASERJET TONER REQUEST REQUESTOR NAME DATE DEPARTMENT

TONER FORM

LaserJet Toner Request

Requestor Name: __________________________ Date: ______________

Department: __________________________ Ext: ______________

Room: _______________

Toner Use: (circle one) LAB OFFICE

Toner Type (check one)

(TONERS IN STOCK ARE LISTED BELOW) A or X designation will fit your TYPE of printer.

____ 00A HP LaserJet 4V 4MV

____ 03A HP LaserJet 5P 5MP 6P 6MP

____ 06A HP LasetJet 5L 6L

____ 09A HP LasetJet 5si MX

____ 10A HP LaserJet 2300DN

____ 11X HP LaserJet 2420

____ 12A HP LaserJet 3052

____ 13A HP LaserJet 1300

____ 27X HP LaserJet 4000 4000N 4000T 4000TN 4050N

____ 29X HP LaserJet 5000 5000GN 5000N 5100

____ 38A HP LaserJet 4200N or 4300N

____ 42X HP LaserJet 4250

____ 43X HP LaserJet 9050

____ 49X HP LaserJet 1320 OR LaserJet 3390

____ 51X HP LaserJet P3005

____ 53X HP LaserJet P2015

____ 61A HP LaserJet 4100N

____ 64A HP LaserJet P4015

____ 82X HP LaserJet 8100D

____ 96A HP LaserJet 2100 2100M 2100TN 2200D 2200DN

____ 98A HP LaserJet 4 4M 4M Plus 5M 5N 5MP

Procedures:

Please fill out Toner Request completely and hand carry or fax this form to the Technology Center (Room AD208) Fax # 609-570-3842 (in house Fax to 3881)
We can only give out one Toner per Request
The old Toner Cartridge must be exchanged for the new Toner. MCCC also recycles small Desk Jet cartridges. However, ITS does not stock these items.

Rev. 02/11/2009 sdh Page 1